Heart Attacks Are More Serious If They Occur At Certain Times Of The Day

People who have a heart attack are likely to be more seriously affected if
the attack happens in the morning, reveals research published ahead of
print in Heart journal.


Heart attacks that occur between 6am and noon are more likely to leave a
20% larger area of dead tissue (infarct) caused by the attack, which is
more serious for the person affected, than at any other time of the day.


It is well established that a person's 24 hour body clock influences
several cardiovascular physiological processes including the incidence of
heart attacks, which tend to happen more around the time when a person is
waking up from sleep, but what is less known is the extent of damage that
this leads to.


Researchers in Madrid, Spain set out to determine the impact of time of
day
of a heart attack on the size of the dead tissue (infarct) caused in
patients with an ST segment elevation myocardial infarction (STEMI) - a
type of heart attack caused by a prolonged period of blocked blood supply.


They analysed data on 811 patients with a STEMI heart attack admitted to
the coronary care unit of Hospital Clinico San Carlos in Madrid between
2003 and 2009. They calculated the size of infarct by looking at enzyme
release in patients.


The time of STEMI onset was divided into four 6-hour time periods in phase
with 24-hour body clock rhythms.


Patients with the largest infarct size were found to be those who had a
heart attack in the dark to light transition period of 6am to noon. These
patients were found to have around a 21% higher level of enzymes in this
period (which indicated a larger infarct size) than patients who had their
heart attack between 6pm and midnight.


The greatest number of patients (269) had their heart attack in the 6am to
noon period, followed by 240 patients who had their attack between noon
and
6pm, 161 during the 6pm to midnight period, and 141 between midnight and
6am.


They also found that patients with a STEMI that happened in the anterior
wall of the heart were left with a larger size of infarct than patients
whose heart attacks happened in other locations.


The authors conclude: "If confirmed, these results may have a significant
impact on the interpretation of clinical trials of cardioprotective
strategies in STEMI."


Source
HEART


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